Section 51215.11 - Pediatric Subacute Care Unit -Ventilator Weaning(a) Each pediatric subacute care unit shall define, implement and maintain a system for assessing, on admission and at least quarterly, those pediatric patients who are dependent, in part or completely, on mechanical ventilation for the appropriateness of reduction or elimination of such dependence.(b) Ventilator weaning services performed in the pediatric subacute care unit shall be covered separately for the purpose of decreasing or eliminating dependence on mechanical ventilation, subject to the following criteria: (1) The pediatric subacute care patient shall be evaluated and deemed appropriate for a weaning trial by a physician with knowledge of and experience in pediatric mechanical ventilation care and who documents, at a minimum, the history of ventilator dependence, previous weaning attempts, an a description of the weaning plan of treatment specifying measurable functional goals within specified time frames and post-weaning stabilization care intensity and duration.(2) The appropriate health care professional, as the result of a comprehensive patient assessment, shall develop a plan of treatment which shall be integrated into an individualized comprehensive plan of care consistent with an interdisciplinary team approach in meeting the child's needs. A plan of treatment specifying measurable functional goals within specified time frames shall include but not be limited to: (A) A respiratory care practitioner's plan of treatment that provides documentation of needed respiratory care practitioner time greater than the three hours in a day, as required by Section 51215.8(t).(B) A nursing plan of treatment that documents the need for registered nurse assessments and subsequent skilled nursing care interventions at specified intervals, but in any case, more than three times in every 24 hours.(c) Ventilator weaning services shall be covered separately from the pediatric subacute care services authorized in accordance with Section 51335.6(c).(d) Ventilator weaning requests shall be subject to the standards of medical necessity as set forth in Sections 51303(a) and 51340(e). Authorization requests shall be initiated by the facility. (1) For the initial request for ventilator weaning, a treatment authorization request (TAR) shall be submitted within 10 working days of the development of the patient's plan of treatment accompanied by the documentation in (b) of this section as appropriate.(2) For reauthorization or requests for continuation of ventilator weaning, a TAR shall be accompanied by a statement describing the pediatric subacute care patient's progress and decreased ventilator dependence achieved and the information required in (b)(1) of this section updated to document continued medical necessity of these services.(3) Pediatric subacute care patients for whom ventilator weaning is authorized shall remain eligible for pediatric subacute care services authorized in accordance with Section 51335.6(c) for the duration of authorization period for ventilator weaning.Cal. Code Regs. Tit. 22, § 51215.11
1. New section filed 6-30-97 as an emergency; operative 6-30-97 (Register 97, No. 27). A Certificate of Compliance must be transmitted to OAL by 10-28-97 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 6-30-97 order transmitted to OAL 10-22-97 and filed 11-26-97 (Register 97, No. 48). Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Section 14132.25, Welfare and Institutions Code.
1. New section filed 6-30-97 as an emergency; operative 6-30-97 (Register 97, No. 27). A Certificate of Compliance must be transmitted to OAL by 10-28-97 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 6-30-97 order transmitted to OAL 10-22-97 and filed 11-26-97 (Register 97, No. 48).